Because of their strenuous physical lifestyle, soldiers have a 10x higher risk of ACL tears than the general population. Here’s what you need to know to recover.
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The effects of anterior cruciate ligament reconstruction (ACLR) surgery in athletes are more widely reported, but it’s a problem for soldiers too. Studies show that military service members are 10 times more likely to experience an ACL injury than the general population.
Although ACL reconstruction methods may vary, the long-term effects they can have on a soldier’s job performance and quality of life are uniformly dangerous. Because of the strenuous lifestyle soldiers live and the peak physical conditioning they must maintain, a torn ACL could derail a military career.
For a soldier, an ACL tear can lead to early discharge and possibly permanent disability. If you have medical records of an ACL surgery, you may be barred from entering because of an existing prior-to-service (EPTS) medical condition.
Where Is Your ACL?
An ACL is one of four ligaments in your knee that connect the muscles around your thigh bone (femur) and shin bone (tibia). You may notice that your legs only bend at the knees in one direction. That’s a result of your kneecap and these ligaments.
Your medial collateral ligaments (MCL) are located on the inside of your knees and keep them from bending in. The lateral collateral ligament (LCL) is located on the outside of your legs and stops your knee from bending out. The anterior and posterior cruciate ligaments (PCL) are located in the middle of your knees and keep the bones from sliding from front to back.
When your ACL is torn, you are more at risk of having your shin bone slide in front of your thigh bone while walking, running, and pivoting to turn.
Because women have a wider pelvis and smaller ligaments, the angle and structure of their bodies make them more vulnerable to ACL injury than men. Hormones and neuromuscular differences also play a part in these differences.
When I tore my ACL, I heard a popping sound that’s been widely reported by anyone who has experienced this injury. I didn’t feel pain personally, but moderate-to-severe pain is commonly reported. It starts somewhat sharp like a paper cut then starts to ache as the knee swells, typically within an hour of the injury.
Although my knee started swelling, the injury itself was relatively painless. However, what was undeniable was the change in how I walked.
Imagine getting used to driving the same car for years and then suddenly buying a new one. It takes time to get used to the feel of everything, and I had to adjust my stride to account for the new way my leg works.
You never know when a torn ACL will happen, but when it does, your best bet is to ice your knee, stay off of it, and see a doctor right away.
It may be a small ligament, but a torn ACL takes longer to recover from than a broken bone. Whether it requires surgery depends on whether the torn ACL is complete or partial. While some people report recovery in as little as six months after surgery for a complete ACL tear, generally you can expect to be out of action for nine months.
But recovery is not automatic; you’ll spend that time using crutches and undergoing physical and occupational therapy. In the military, you’re placed on a medical profile that limits what physical activities you’re allowed to perform. During this time, it’s natural for you to feel mental anguish, anxiety, depression, and uncertainty about your future.
Although you may never return to 100%, you’ll still be able to perform basic PT eventually. Many of these calisthenics are great for your recovery, and other exercises are designed to specifically help strengthen your legs after a torn knee ligament.
As mentioned above, an ACL tear can be either complete or partial. A complete ACL tear will require surgery, but a partial tear may be treated without it. An orthopedic study at Sweden’s Lund University of 121 active young adults found many patients who skipped ACL surgery ended up never needing it in the first place.
However, your ACL isn’t the only problem that could have occurred with the injury. Besides the other three ligaments mentioned, you could also have damage in the meniscus (the cartilage protecting your knee bones) and other parts of your leg.
It may be helpful to speak with a civilian ACL specialist who is more interested in your recovery than the threat of paying long-term disability should you require a medical discharge. Regardless of whether you’re discharged or return to active duty, there will be some lifestyle changes required after ACL surgery.
A torn ACL doesn’t guarantee you’ll be permanently disabled; a 2017 study of 470 active-duty patients found just over 50% of patients were either put on medical profiles for physical limitations or deemed unable to return to duty after ACL surgery. An earlier study reported the rate of return at 69.9%, and the difference could be due to more information becoming available in recent years.
Far too often, surgeons focus on the procedure, and soldiers are left with only basic care to help through recovery. Don’t be afraid to ask questions and involve a team of rehabilitation specialists to help through recovery. It’s tempting to try to be “high speed” and soldier through a knee injury, but don’t be afraid to take time to recover.
It’ll take both physical and occupational therapy to return to full health after ACL surgery, but it’s possible to do it. If you have any questions or need to know more about your situation, feel free to reach out with any questions you may have.